氟康唑早期经验性治疗ICU真菌感染的临床效果.docVIP

氟康唑早期经验性治疗ICU真菌感染的临床效果 　　[摘要] 目的 评价氟康唑早期经验性治疗ICU真菌感染的临床效果。 方法 回顾性分析解放军第二六一医院2010年1月～2012年12月收治的真菌感染患者67例的临床资料，将患者分为对照组和观察组。对照组患者在临床证据证明为真菌感染后给予氟康唑行抗真菌治疗，观察组患者在真菌感染早期即行抗真菌治疗。两组患者治疗均应用氟康唑，时间为14 d，治疗过程中根据患者肾功能情况调整用药剂量。对两组患者治疗的总有效率进行比较。 结果 对照组、观察组的抗真菌感染总有效率分别为59.38%、91.43%，差异有统计学意义（P 0.05）。 结论 应用氟康唑对ICU真菌感染患者进行早期经验性治疗有助于提高抗真菌感染治疗有效率，值得临床推广。 　　[关键词] ICU；真菌感染；氟康唑；早期经验性治疗 　　[中图分类号] R379 [文献标识码] A [文章编号] 1673-7210（2014）09（a）-0074-05 　　[Abstract] Objective To evaluate the clinical efficacy of Fluconazole in early empirical treatment of fungal infection. Methods The clinical data of 67 patients with fungal infection admitted to the 261st Hospital of PLA from January 2010 to December 2012 was analyzed retrospectively. The patients were divided into control group and observation group. Patients in the control group received antifungal therapy with Fluconazole after the clinical evidence of fungal infection. The patients in observation group received antifungal therapy in the early stage of fungal infection. Both groups were given Fluconazole， lasting for 14 d. The dosage was adjusted according to the renal function of patients during the treatment. The total effective rate of the two groups was compared. Results The total effective rate of antifungal infection in the control group and observation group was 59.38%， 91.43% respectively， the difference between the two groups was statistically significant （P 0.05）. Conclusion Application of Fluconazole in early empirical treatment of fungal infection in ICU is helpful to improve the effective rate of antifungal infection， which is worthy of clinical popularization. 　　[Key words] ICU； Fungal infection； Flueonazole； Early empirical treatment 　　ICU患者均病情危重，病情危重的患者在有着严重基础疾病的同时，还需要接受深静脉置管、气管插管、气管切开等多种侵袭性的操作，这就使得ICU患者发生侵袭性真菌感染（invasive fungal infections，IFI）的概率明显高于普通患者，发生IFI将大大增加患者的病死率[1]。IFI的临床确诊比较困难，主要的确诊手段有活体组织学检查和（或）实验室真菌培养结果，这两种检查手段均较耗时，等待临床确诊后进行抗真菌治疗往往已经丧失了最佳的治疗时机。既往的研究结论显示早期经验性治疗是挽救危重IFI患者生命的必要手段[2]。为了能有效地治疗ICU患者的真菌感染，本